- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02855580
Integrating Pharmacogenomic Testing Into a Child Psychiatry Clinic (PGX)
Study Overview
Status
Detailed Description
This project will assess the feasibility of implementing pharmacogenomic testing (PGX) for specific genes involved in the metabolism of antidepressants (CYP2D6 and CYP2C19) into the child psychiatry clinic at UF.
Although not widely implemented to date, naturalistic studies in adult psychiatry populations have shown that PGX testing can improve patient outcomes, increase medication adherence, and reduce costs. However, there have been no studies of psychiatry-focused PGX testing in children. One in every four children and adolescents suffers from a mental illness (more than half have a mood or anxiety disorder) that is severe enough to impact their functioning at school, at home, or in other important areas. Although psychotherapy remains the first line treatment for children with mild or uncomplicated symptoms, the use of psychotropic medications in children has increased steadily over the last decade. These medications are effective for many children, but carry a substantial risk of side effects, including gastrointestinal, cognitive, systemic, and psychiatric (including treatment emergent suicidal ideation). For most treatment responders, improvement is typically seen four to eight weeks after the target dose has been achieved (twelve weeks for obsessive compulsive disorder). Thus, identifying the best medication options prior to treatment initiation could decrease the likelihood of side effects severe enough to require medication discontinuation or changes, and minimize the time to response. In this study, 50 children and adolescents with major depression, anxiety, or obsessive compulsive disorders who are beginning treatment with a new antidepressant will be recruited and PGX testing will be conducted. Twenty five children will be randomized to receive PGX testing prior to starting/changing medications and 25 to receive treatment as usual (these children will receive their PGX results at the end of 12 weeks). Members of the UF Health Personalized Medicine Program will provide education to the prescribing clinicians about PGX testing and will create patient-specific consultations regarding the PGX results.
Assess clinicians' and parents' willingness to use PGX testing in making treatment decisions, as well as their knowledge and beliefs about PGX testing (pre-and post-study). Also assess, as pilot data for a larger randomized controlled trial, differences in side effect profiles, treatment adherence, and symptom improvements between the PGX cases and controls.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Florida
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Gainesville, Florida, United States, 32606
- Child Psychiatry Clinic at University of Florida
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Male or female age 8 to 20 years old
- Have been diagnosed with and receiving treatment for mood disorder, anxiety, or obsessive compulsive disorder
- Receiving treatment at UF child psychiatry clinic
Exclusion Criteria:
- Children with a primary diagnosis of autism
- High risk for suicide
- Children determined by UF psychiatrist to be too ill to tolerate waiting two weeks to begin medication treatment
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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PGX Testing Based Treatment
Treatment will be administered based on the results that are obtained from the pharmacogenomics testing.
Results from testing will be provided two weeks after specimen collection.
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Standard of Care Treatment
Treatment will be based off of the standard of care.
Results from pharmacogenomics testing will be provided at the end of the study.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Antidepressant Tolerance
Time Frame: From week 0 through week 12
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The feasibility of pharmacogenomic (PGX) testing (specifically for the cytochrome P450 and 2C19 genes) prior to initiating treatment in a child and adolescent population will be measured through medication compliance and frequency of medication changes as described in the patient's medical record.
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From week 0 through week 12
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Symptom Severity-Depression
Time Frame: From week 0 through week 12
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Depression will be assessed using the Children's Depression Inventory (CDI)
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From week 0 through week 12
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Symptom Severity-Anxiety
Time Frame: From week 0 through week 12
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Anxiety will be assessed using the Screen for Child Anxiety Related Emotional Disorders (SCARED)
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From week 0 through week 12
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Symptom Severity-Obsessive Compulsive Symptoms
Time Frame: From week 0 through week 12
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Obsessive compulsive symptoms will be assessed using the Children's Florida Obsessive Compulsive Inventory (C-FOCI).
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From week 0 through week 12
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Side effects
Time Frame: From week 1 through week 12
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Assess effects associated with AD treatment using a standardized questionnaire commonly used in clinical trials of children and modified for this study.
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From week 1 through week 12
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Carol A Mathews, MD, University of Florida
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB201601035
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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